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PERI-OPERATIVE NUTRITION -MARKET RESEARCH SURVEY

  1. In the pre-operative phase, the traditional and strict rule “nothing by mouth from midnight to the day is still being followed. *

  2. For the diagnosis of malnutrition, the American Society of Parenteral and Enteral Nutrition (ASPEN) have recommended methods for assessing the nutritional status of hospital patients. In Indian scenario, same are being followed. *

  3. High Body Mass Index (BMI) is associated with increased frequency of postoperative complications including longer stay in the intensive care unit, delayed start of oral nutrition, etc. *

  4. The current ESPEN guidelines state that ‘Oral nutritional intake shall be continued after surgery without interruption and oral intake, including clear liquids, shall be initiated within hours after surgery in most patients. In Indian scenario, same are being followed. *

  5. Protein malnutrition affects defense against infection by disrupting inflammatory response. This clinically relevant in your practice. *

  6. Inadequate Nutritional status such as Low dietary protein intake, Low serum albumin concentration and Low BMI are associated with an increased risk to develop chronic wounds. This is clinically relevant in your surgical patients. *

  7. Fructo-oligosaccharides (FOS) helps to maintain gut health. This is clinically relevant in your surgical patients. *

  8. During the first week of critical illness, patients lose roughly 2% of muscle mass per day. This is clinically relevant in your patients with critical illness undergoing surgery. *

  9. To correct deficiencies, optimize wound healing, support immune function are the goals of micronutrient supplementation in majority of acute and chronic illness/ injuries. It is clinically relevant in your practice. *

  10. Excess 0.9% saline is detrimental in the perioperative period and salt and water overload of >2.5 L is associated with adverse outcome. Please share your observations. *
  11. Dietary fiber attenuates glycaemia by delaying gastric emptying, amylolysis, sugar diffusion and absorption. It is relevant in the clinical practice. *

  12. During peri-operative period, appropriate macro and micronutrient nutritional intake support the increased nutritional needs during the hypermetabolic state. It is relevant in the clinical practice. *

  13. Nutritional risk score (NRS) is validated for surgical patients and should be performed days before surgery. *

  14. Preoperative muscle mass is critical to postoperative outcome. It has relevance in the clinical practice. *

  15. Inflammation is a marker for surgical complications. CRP profiling is useful and being used in your clinical practice. *

  16. As per your clinical experience, which are the most common reasons for peri-op malnutrition in patients visiting your OPD? *
  17. Perioperative nursing in the hospital and community after discharge is a key component for good outcome. This is being observed in your clinical practice. *

  18. Malnutrition persists to be a significant burden on health care facilities worldwide. This has clinical relevance based on your experience from patients undergoing surgery or procedures. *

  19. Nutritional status is a strong predictor of postoperative outcomes. Kindly share how you evaluate nutritional status of your patients undergoing surgery or procedures. *
  20. In your practice, what percentage of surgical patients undergoing major surgery, are malnourished or at risk of malnutrition? *

  21. Protein catabolism is elevated during the stress response. This is also being observed in your practice. *

  22. Loss of strength and functionality follows from muscle atrophy. Please share what advice you give to your patients undergoing surgery. *
  23. Nutrition plays an essential role in injury recovery and rehabilitation. Is it relevant as per your clinical experience with surgical patients? Please share some of your observations / findings. *
  24. Surgery evokes a catabolic response. Please mention few relevant observations based on your experience with patients undergoing surgery or procedures. *
  25. As per ESPEN guidelines nutrition supplementation post-surgery results in to enhanced recovery. Please share your observations? *
  26. Reduced appetite is one of the challenging factors that limits consumption of high-quality proteins. How you address this issue in your patients undergoing surgery or procedure? *
  27. In patients with sepsis and acute respiratory distress syndrome, muscle wasting during the first 7 days of ICU was found to be a predictor for ICU-acquired weakness. Have you observed this in your patients anytime? If any of your peri-op patients land into this situation, what will be your plan of management. *
  28. Patients with malnutrition has shown to have delayed wound healing. Have you observed this in your patients anytime? If any of your peri-op patients land into this situation, what will be your plan of management? *
  29. Strict Fasting procedures have restricted nutritional intake in the hours before surgery due to concerns of regurgitation or aspiration under anesthesia. Is it clinically relevant for patients undergoing surgery or procedures where they can suffer from malnutrition? If any of your peri-op patients land into this situation, what will be your plan of management? *
  30. Earlier post-operative feeding is associated with reduced infection complications, improved healing, and decreased length of stay. Does this have significance in the clinical practice and have you observed any relevant findings in your patients undergoing surgery or procedures? What advice you give to such patients? *